What are healthcare-associated infections?
Healthcare-associated infections (HCAI) are infections that are acquired as a result of health care. The burden of healthcare-associated infections has mainly been in hospitals where more serious infections are seen. It is estimated that at any one time 9% of all inpatients have infection acquired whilst in hospital. The extent of healthcare associated infections acquired outside of the hospital setting (i.e. in community health care) may increase with more invasive procedures such as minor surgery taking place in the primary care setting.
Why are healthcare-associated infections a problem?
Healthcare-associated infections have always been associated with healthcare provision. There are many factors that contribute to the current problem and some of the main ones are listed below.
- More susceptible patients being treated than ever before (older patients or patients with severe or chronic diseases).
- Advances in treatments that improve patient survival but at the same time leave them more vulnerable to infections, either through invasive procedures (e.g. indwelling lines into veins, access for dialysis or artificial ventilation) or suppression of the immune system (e.g. treatments for leukaemias, cancers, and transplant patients).
- Increased patient movement between wards due to pressures on hospital beds.
- Wider use of antibiotics and the emergence of antibiotic-resistant micro-organisms.
What impact do healthcare-associated infections have?
Healthcare-associated infections directly affect the patient, their carers and employer in several ways, such as severe or chronic illness, pain, anxiety, depression, longer stay in hospital, reduced quality of life and loss of earnings or sometimes death.
They also impact on the health service in terms of extended lengths of stay of affected patients, the costs of diagnosis and treatment of the infections and their complications, and the costs of specific infection control measures. Related bed and ward closures and postponed admissions may also add to the overall burden. Antibiotic costs may be further increased if the infection is also due to a resistant micro-organism, as it is more expensive to treat these types of infection.
Are healthcare-associated infections preventable?
Not all healthcare associated infections can be prevented, as they are often the price paid for advances in treatments. However, it has been estimated that around 15% to 30% could be avoided through strengthened arrangements for prevention and control, and better application of existing knowledge and good practice. One of the most important prevention activities for HCAI is hand washing after patient contact and local and national initiatives are promoting this.